Over 7 million of the world's 17 million refugees remain "warehoused" under conditions of confinement, raising serious human rights issues about the treatment of people fleeing oppression.
Last year, Australia abolished mandatory detention for asylum seekers, admitting that the policy had failed and releasing all confined children and their families.
Yet Britain increasingly appears to be pursuing this policy. About 25,000 people have been held in 10 removal centres in the past year and the latest immigration bill seeks to expand detention facilities and the capacity to effect forced removals, write authors Mina Fazel and Derrick Silove.
Medical observations in Britain concur with those from Australia, with attending doctors noting that detainees, particularly those held for long periods, suffer from profound hopelessness, despair, and suicidal urges. Doctors face ethical challenges in balancing the responsibility to provide care without discrimination to a vulnerable group against the risk of becoming complicit in a system that by its very nature causes psychological harm.
Every nation has a duty and a right to monitor those who cross its borders, say the authors. Nevertheless, considerations of national security need to be balanced against our obligations to treat asylum seekers with justice, dignity, and humanity in the spirit of the UN Refugee Convention (1951).
It should be noted too that the UK has a relatively low intake of asylum seekers per head of population compared with Germany, the United States, Australia, and France.
Media claims that Britain faces a deluge of asylum seekers and that refugees may be terrorists serve only to increase the risk that "tough" but ultimately damaging measures will be implemented, aimed to allay public fears rather than to confront the genuine psychological needs of people fleeing persecution, they warn.
The lessons for Britain are clear. Australia has acknowledged the failure of detention policy. There is ample evidence that models of community accommodation for asylum seekers lead to better mental health outcomes and that humane but rigorous forms of monitoring can still be instituted in these settings.
By continuing to document the psychosocial impact of detention, the medical profession is well placed to add its expert voice in shaping humane immigration policies, they conclude.